Objective To explore the application of medical thoracoscopy in the extraction of intrapleural foreign bodies. Methods The clinical data of 2 cases of adult intrapleural foreign bodies were analyzed and reviewed in combination with related literatures. Results One patient with foreign body located in the right intrapleural cavity was a closed drainage tube with a broken intrapleural cavity, and the foreign body was removed with a cold trap and a thoracoscopic stab card, while in one patient, the foreign body was located in the left intrapleural cavity and was a guide wire of a single lumen central vein. Endoscopic biopsy forceps were used to remove the foreign body. Searching the literature at home and abroad, there were 8 reports of thoracoscopic removal of intrapleural foreign bodies and 9 cases. The main cause of intrapleural foreign bodies was iatrogenic improper operation, accounting for 66.7% of the total number of cases. the most common types of intrapleural foreign bodies are ruptured closed thoracic drainage tubes and puncture needles. Conclusion Medical thoracoscopy can be used to remove foreign bodies in the intrapleural cavity, which has certain application value and prospects.
Objective To investigate the relationship between the expressions of mismatch repair （MMR） genes （include hMLH1 and hMSH2） and clinicopathological features and prognosis of hereditary nonpolyposis colorectal cancer （HNPCC）. Methods Immunohistochemistry method （Elivision-two step） was used to test expressions of hMLH1 and hMSH2 proteins （both hMLH1 and hMSH2 protein-positive delimited as MMR protein-positive） in 48 patients with HNPCCaccording to revised Bethesda guidelines， and analyzed the relationship between the expression of MMR protein and clinicopathological features and prognosis of HNPCC. Results Loss rate of hMLH1 protein （20.83%，10/48） was signi-ficantly higher than that of hMSH2 protein （8.33%，4/48）， Ρ＜0.05， and positive expression rate of MMR protein was 70.83% （34/48）. Expression of MMR protein was related with tumor infiltration depth （Ρ＜0.05）. Survival rate of patients with expression and without expression of MMR protein was 85.29% （29/34） and 85.71% （12/14）， respectively， the survival curves of them didn’t significantly differed from each other （Ρ＞0.05）. Conclusions Loss rate of hMLH1 protein is higher than that of hMSH2 protein. Expre ssions of hMLH1 and hMSH2 protein are related with tumor infiltration depth， but not related with prognosis.
Objective To investigate the cl inical characteristics and methods of diagnosis and treatment of multiple level thoracolumbar spinal fractures. Methods From March 2002 to March 2006, 17 patients with 35 thoracolumbar spinal fractures were treated, 13 males and 4 females, aged 21-52 years old (36.4 on average), among whom there were 10 cases of traffic accident injury and 7 of high fall ing injury. One fracture was located at T2, 1 at T3, 1 at T10, 4 at T11, 6 at T12, 5 at L1, 3 at L2, 7 at L3, 5 at L4, and 2 at L15, with a total of 35 segments including 26 segments with unstable fractures and 9 segments with stable compression fractures. According to the Frankel grade, there was 1 case of grade A, 1 of grade B, 2 of grade C, 5 of grade D and 8 of grade E. The preoperative height of the anterior border of the vertebral body was (20.8 ± 3.8) mm and the preoperative kyphosis angle was (16.2 ± 3.4)°. All the unstable fractures were performed operation. Sixteen injured vertebras were treated with long-segment pedicle screw internal fixation; 8 were treated with short-segment pedicle screw internal fixation, and 2 were treated with anterior fusion and fixation. Five injured vertebras with stable compression fractures were not treated and 4 were treated with pedicle screw implantation. Results The operation time was 1.8-4.2 hours and the amount of blood loss was 300-900 mL. The incisions obtained heal ing by first intention after the operation. All 17 patients were followed up for 13-41 months (18 months on average), and radiological evaluation showed no failure of the internal fixation. After the operation, the Frankel scale assessment showed that 1 patient of grade A improved to grade B, 1 of grade B improved to grade C, 1 of grade C improved to grade D, 1 of grade C improved to grade E, 5 of grade D improved to grade E, and 8 of grade E had no improvement. At the final postoperative follow-up, the height of the anterior border of the vertebral body was (31.9 ± 3.2) mm and the kyphosis angle was (6.8 ± 3.7)°, which were significantly different from those of preoperation (P lt; 0.01). Conclusion The treatment of multiple level thoracolumbar spinal fractures should be individual ized according to the patients’ actual conditions in order to obtain decompression and stabil ity of spines.
Objective To investigate the features of extracolonic carcinoma spectrum in Northeast Chinese with hereditary nonpolyposis colorectal cancer. Methods The extracolonic carcinoma spectrum’s characteristics of 85 families registered in strict conformity with the HNPCC Amsterdam criteriaⅡwere analyzed retrospectively. Results In the 85 HNPCC families， the tumorous patients were 509 cases，the primary tumors were 589 cases， among the total consisted of 219 cases of colon cancer， 91 cases of rectal cancer，and 279 cases of extracolonic cancer， the most common extracolonic carcinoma was lung cancer. Conclusions Extracolonic carcinoma is an important part of cancer spectrum in HNPCC family， and the common extracolonic carcinoma in Northeast of Chinese are lung cancer， gastric cancer， endometrial cancer， liver cancer， and esophagus carcinoma.
Objective To analyze the clinical pathological features of patients with hereditary nonpolyposis colorectal cancer （HNPCC） in northeast Chinese. Methods The clinical data of 101 probands （HNPCC group） from 1982 to 2011 in the Fourth Affiliated Hospital of China Medical University and Tumor hospital of Liaoning Province and 272 patients with sporadic colorectal cancer （sporadic CRC group） in the same period were collected. The clinicopathologic features were compared in two groups. Results In the HNPCC group， the age of onset was younger than 45 years old in 24 patients （23.8%）， proximal colon in 31 （30.7%）， multiple primary carcinomas in 26 （25.7%）， extracolonic carcinoma in 13 （12.9%）， mucinous adenocarcinoma in 32 （31.7%）， phaseⅠandⅡin 68 （67.3%）， high-middle differentiation in 70 （69.3%）， and lymph node metastasis in 33 （32.7%）， while in the sporadic CRC group were 12 （4.4%）， 54 （19.9%）， 15 （5.5%）， 11 （4.0%）， 30 （11.0%）， 127 （46.7%）， 152 （55.9%）， and 140 （51.5%）， respectively. There were significant differences between the HNPCC group and the sporadic CRC group （P＜0.05）. Meanwhile， extracolonic carcinomas in the HNPCC group were endometrial cancer in 3， bladder cancer in 3， breast cancer in 2， brain tumor in 2， ovarian cancer in 1， gastric cancer in 1， and lung cancer in 1. Conclusions Northeast China HNPCC patients with several particular clinicopathologic features such as early onset， frequent localization in proximal colon， proclivity of synchronous and metachronous tumors， excessive mucinous adenocarcinoma， less poorly differentiated tumors， lymph node metastasis， early stage of tumor， and so on. Therefore， clinicopathologic feature is still a preferred method of diagnosis of HNPCC patients or suspected HNPCC patients.